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Integrating Airway Disorders into Treatment

So as we move into the future of complete dentistry, we're going to be finding that we will be doing more and more integration of airway disorders into our treatment planning and even into solving occlusal problems.

So for example, when someone's evaluated and we are able to identify that they have a breathing disorder or an airway disorder, we recognize that part of their airway disorder may be that they're now a mouth breather. As a result of that, their tongue remains low in the floor of their mouth, and as a result of that, their maxillary arch is not developed and they have crowding of the maxillary and maybe the mandibular arches.

 

What needs to be addressed?

We want to correct their occlusal problem, but also recognizing that behind that could be an airway disorder. So we're going to be looking at it from where the blockage is in the airway.

Are they unable to breathe through their nose? Does that need to be addressed?

Is their tongue dropped in the back of their throat during sleep and obstruct their airway, and now they have sleep-disordered breathing? Does that need to be addressed?

Could it be that doing orthodontics or Invisalign, some type of clear aligners, they can expand the dental arches and give more room for the tongue? This would help remove it from the back of the throat if the patient then closes their mouth and begins to breathe through their nose.

How will we address it?

So we'll be looking at things like oral myofunctional therapy, where we're re-training patients on how to breathe properly through their noses. We'll be looking very closely, as occlusal restorative dentists, at things like allergies and whether that's obstructing the airway and that needs to be addressed through an allergist, perhaps through:

  • an ENT
  • nasal surgery
  • orthodontic expansion
  • nasal breathing and keeping the mouth closed
  • proper tongue positioning
  • releasing a tongue tie that's forcing the tongue to stay low and back as opposed to filling the maxillary arch

So these are the things that are going to be integrated into our treatment plans, often as a phase-one type treatment before doing our definitive occlusal therapy. And I think it's very exciting because it really expands our model, not only to do better occlusal therapy, but to do better whole-health therapy at the same time.

Learn more about airway and sleep disorders at our International Airway Symposium

How to Easily Plan Patient Centered Dental Treatment

Dr. DeWitt “Witt” Wilkerson graduated from the University of Florida College of Dentistry in 1982, the same year he joined the Dawson private practice group in St. Petersburg, Florida. Witt is currently a Senior Faculty member and Director of Dental Medicine at The Dawson Academy. He is Past President of the American Equilibration Society(AES). Witt currently serves as President of the American Academy for Oral-Systemic Health(AAOSH), and is an Adjunct Professor in the Graduate Program at the University of Florida College of Dentistry. He has formerly served as an Associate Faculty Member and Special Lecturer at the L.D. Pankey Institute. Dr. Wilkerson lectures both nationally and internationally on the subjects of Restorative Dentistry, Dental Occlusion, TM Disorders, Airway/Dental Sleep Medicine, and Integrative Dental Medicine.